Differences among a modern cohort of BRCA mutation carriers choosing bilateral prophylactic mastectomies compared to breast surveillance Journal Article


Authors: Gilbert, E.; Zabor, E. C.; Stempel, M.; Mangino, D.; Heerdt, A.; Pilewskie, M.
Article Title: Differences among a modern cohort of BRCA mutation carriers choosing bilateral prophylactic mastectomies compared to breast surveillance
Abstract: Background: Women with a BRCA mutation have significantly elevated breast cancer risk, which can be reduced by >90% with bilateral prophylactic mastectomy (BPM). We sought to compare a cohort of BRCA mutation carriers choosing BPM versus breast surveillance to better elucidate factors that may impact decision making. Methods: Women with a BRCA mutation were retrospectively identified from a prospectively maintained database. The surveillance cohort (n = 313) consisted of women seen in a high-risk clinic between 2014 and 2016, while the surgery cohort (n = 142) consisted of women who underwent BPM between 2010 and 2016. Clinical and familial factors were compared between the groups. Results: Women choosing BPM were more likely to have a BRCA1 than BRCA2 mutation compared with the surveillance group (57 vs. 45%, p = 0.02) and were less likely to have a personal history of ovarian cancer (10 vs. 20%, p = 0.01). Furthermore, women undergoing BPM were more likely to be married (78 vs. 62%, p = 0.01), to have more children (median 2 vs. 1, p < 0.001), and to have undergone a prophylactic oophorectomy (61 vs. 37%, p < 0.001). Women choosing BPM had more first-degree relatives (63 vs. 48%, p = 0.01) or a sister (23 vs. 14%, p = 0.02) with a history of breast cancer and were more likely to have a family member with ovarian cancer under the age of 40 years (9 vs. 4%, p = 0.03). There was no difference in the number of prior breast biopsies or history of atypia/lobular carcinoma in situ. Conclusion: The decision to undergo BPM appears multifactorial, with gene mutation, family history, and relationships appearing to have the strongest influence on decision making. © 2017, Society of Surgical Oncology.
Journal Title: Annals of Surgical Oncology
Volume: 24
Issue: 10
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2017-10-01
Start Page: 3048
End Page: 3054
Language: English
DOI: 10.1245/s10434-017-5976-2
PROVIDER: scopus
PUBMED: 28766223
PMCID: PMC5802967
DOI/URL:
Notes: Article -- Export Date: 4 October 2017 -- Source: Scopus
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MSK Authors
  1. Alexandra S Heerdt
    83 Heerdt
  2. Emily Craig Zabor
    113 Zabor
  3. Michelle Moccio Stempel
    119 Stempel